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Organization

KIST MEDICAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MATTHEW TWERS (PRESIDENT)
(386) 233-0075
Entity
Organization

Contact information

Practice address
1029 S NOVA RD, UNIT D, ORMOND BEACH, FL 32174-9021
(386) 233-0075
(386) 492-4749
Mailing address
6 INVERRAY CT, ORMOND BEACH, FL 32174-8783
(386) 233-0075

Taxonomy

Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary

Other

Enumeration date
06/15/2011
Last updated
06/15/2011
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